NPIMap

Organization Active NPI

Wise Health Professional Corporation

  • Psychiatry Physician
  • Chicago, IL
National Provider Identifier
1891969903
Registry record updated Feb 22, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Psychiatry PhysicianTaxonomy code 2084P0800X
License
036091776 Issued in IL
Legal business name
WISE HEALTH PROFESSIONAL CORPORATION
Practice address
1127 N. Oakley Ave
5TH Floor
Chicago, IL 60622-3507
Phone
(773) 989-9868
Fax
(773) 989-9824
NPI assigned
Apr 18, 2008
Last updated
Feb 22, 2024By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Feb 22, 2024

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name
Dr. Shephali A Patel, M.D.NPI 1063592095
Title
President
Phone
(847) 322-9602

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Psychiatry PhysicianGroup: 193400000X SINGLE SPECIALTY GROUP 2084P0800X 036091776 IL Primary

Addresses

Primary practice location

1127 N. Oakley Ave
5TH Floor
Chicago, IL 60622-3507

Mailing address

1127 N. Oakley Ave
5TH Floor
Chicago, IL 60622-3507
Phone (773) 989-9868

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in IL

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20081110000517 IL Part B Supplier - Clinic/Group Practice 4789743436 Receives reassigned benefits from 14 practitioners
Practice locations: Chicago, IL; Chicago Heights, IL; Crestwood, IL; Evanston, IL; Northbrook, IL; Skokie, IL; Waukegan, IL; Chciago, IL

National Provider Directory

National Provider Directory
Tax ID family
Wise Health Professional Corporation2 organizations share this tax ID, including this one

Other organizations with this tax ID 1

Organizations that report the same tax identification number in the National Provider Directory.

Locations

1044 N Francisco Ave
#505
Chicago, IL 60622
Phone (773) 989-9868

1127 N Oakley Blvd
Fl 5
Chicago, IL 60622
Phone (773) 271-9040

2055 W Balmoral Ave
Chicago, IL 60625
Phone (773) 561-8661

255 W 69th St
Chicago, IL 60621
Phone (773) 224-5900

3710 N Kedzie Ave
Chicago, IL 60618
Phone (773) 564-9070

4621 N Racine Ave
Chicago, IL 60640
Phone (773) 764-2300

4755 N Kenmore Ave
Chicago, IL 60640
Phone (773) 484-6672

4600 Golf Rd
Skokie, IL 60076
Phone (847) 673-8648

Practitioners & affiliated clinicians

Practitioners 15

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

View all 15

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1208476800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1708560000000",
    "number": "1891969903",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1127 N. OAKLEY AVE",
            "address_2": "5TH FLOOR",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606223507",
            "telephone_number": "773-989-9868",
            "fax_number": "773-989-9824"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1127 N. OAKLEY AVE",
            "address_2": "5TH FLOOR",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606223507",
            "telephone_number": "773-989-9868",
            "fax_number": "773-989-9824"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "WISE HEALTH PROFESSIONAL CORPORATION",
        "organizational_subpart": "NO",
        "enumeration_date": "2008-04-18",
        "last_updated": "2024-02-22",
        "status": "A",
        "authorized_official_last_name": "PATEL",
        "authorized_official_first_name": "SHEPHALI",
        "authorized_official_middle_name": "A",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "847-322-9602",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "M.D."
    },
    "taxonomies": [
        {
            "code": "2084P0800X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Psychiatry & Neurology, Psychiatry",
            "state": "IL",
            "license": "036091776",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Chicago, IL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 22, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.